Natural Fertility: The Basics About Age, Ovulation, and Timed Intercourse

This blog post is all about how you can take control of what you can to boost your fertility when it comes to age, ovulation, and sex.

Age and Fertility

If you have listened to my podcasts or read previous blog posts, you know that as you get older your fertility decreases for two reasons. The first is that you start to run out of eggs and the second is your egg quality changes with time. The change in egg quality gives you in increased chance of genetic abnormalities and miscarriage. My take home message is that if you are starting your family earlier, you need to pay attention to what you are doing each month, lifestyle factors and try to optimize your chance of success. It’s important to know that about 80% of couples trying to get pregnant will get pregnant in six months. If you are older than 35, you should get a fertility consult, and if you are younger than 35, wait for up to a year. However, you certainly do not have to wait. 

Ovulation

Regular menstrual cycles are very important in this process because you have to know your ovulation to be able to best time intercourse. You can use apps that use the calendar method to plan, but if your periods are irregular the app will not be putting the correct day of your fertile window. This is important because your egg only lives 24 hours after you ovulate, however sperm can live longer inside the female reproductive tract for up to five days. Another way to test your ovulation is with ovulation predictor kits, cervical mucus monitoring or basal body temperature. 

Ovulation Predictor Kits are like a pregnancy test where you check your urine. You use them once a day and it lets you know when you have an LH (hormone causing you to ovulate) surge. I encourage you to use this once a day between 10:00AM - 2:00PM because the LH surge usually occurs early in the morning and needs time to get to your urine. The positive surge is the day before you ovulate. Your two most fertile days are the day of the positive and the day after. 

Cervical Mucus Monitoring is an inexpensive way to test your ovulation. As that mature egg makes more estrogen, it changes the consistency of your cervical mucus in order to allow sperm to go through. If you stick your fingers in your vagina, pull them out, and there is slippery, stretchy, egg-white mucus between your fingers, this is the type four cervical mucus. This is the most fertile cervical mucus associated with the day of ovulation.

Basal body temperature is basically checking your temperature. After you ovulate, your corpus luteum makes progesterone and the progesterone increases your natural body temperature. So you detect your body temperature every morning before you get out of bed or drink water, record it,  and you will see a half a degree increase in your body temperature when you are ovulating. The important thing to note is that this tells you that you have already ovulated so your fertile window is closed. So your most fertile days are the 2-3 days before your temperature shifts. However, this is helpful to confirm ovulation. Because many other factors go into your body temperature such as drinking, lack of sleep, illness, etc, this is not the best method for everyone.

Let’s talk about Sex

This is the other part of the equation. Many doctors will say to just start having sex every other day around day ten of your menstrual cycle. Since sperm can live in the reproductive tract for several days, you are hitting your most fertile days if you have sex every other day in your fertile window. Some patients hear that and think having more sex must be bad because more ejaculations must lower your fertility. That is not true. If you typically have sex every day, keep doing that. If you don’t have sex that often, don’t burn yourself out and have sex every other day during the whole month. If you had to pick two days to have sex each month, it would be the day before and the day of ovulation. It has been shown that sperm moves rapidly through the reproductive tract. Sperm can be seen in the fallopian tubes within minutes. There is no evidence that laying down after sex or with your legs up to prevent semen from coming out of your vagina and preventing pregnancy. Position also does not matter. There is some evidence that says female orgasm may help sperm transfer through the reproductive tract better. Therefore, whatever position is going to make the woman orgasm is the best one. Let’s talk about lube. Studies have shown that lubricants like KY Jelly and Astroglide are not good. Even saliva and olive oil have been shown to decrease sperm motility. If you need lubricant to have sex, a mineral oil, canola oil, or Pre-Seed are going to be the best. 

When it comes to natural fertility, ovulation and sex are the most important. Next we will talk about how what you consume and your environment play a role in your fertility.

Fertility physician Dr. Natalie Crawford, MD wants you to know all about ovulation. How do you know if you are ovulating? Do birth control pills impact ferti...

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